All codes
T345
T345 – T345
OHIP Other Code · Schedule of Benefits
When to Use
- Use T345 for the initial assessment and management of a patient presenting with a complex, acute condition requiring immediate intervention in a specialized setting.
- Apply this code when the clinical complexity exceeds the scope of a standard consultation (A005) or a routine follow-up visit (A007) due to the intensity of the required diagnostic or therapeutic procedures.
Common Pitfalls
- Billing T345 in conjunction with a standard office visit (A007) on the same day will trigger a rejection for duplicate service unless distinct clinical circumstances are clearly documented.
- Failure to meet the specific time-based or procedural requirements defined in the Schedule of Benefits for T345 often leads to automatic audit flags and subsequent recovery of funds.
Billing Tips
- Ensure the diagnostic code linked to T345 reflects the high-acuity nature of the encounter to justify the premium fee compared to lower-tier assessment codes.
Provider Fee$395.20
Specialist Fee$395.20
Effective: February 1, 2011
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